Feature: Study shows early promise for imaging pancreatic cancer

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A new study being conducted at University Hospitals’ Seidman Cancer Center in Cleveland is showing some promising signs in the effort to combat pancreatic cancer, though the results are very preliminary, according to Pablo Ros, MD, chairman of radiology at University Hospitals/Case Western Reserve University and the study’s principal investigator.

Ros and colleagues are testing whether administering a synthetic version of the naturally occurring hormone secretin could help produce better pre-surgical images of pancreatic tumors. After the first couple cases, the early results have researchers optimistic.

“It’s very preliminary, but in such a devastating disease as pancreatic cancer where there has been little improvement  in survival for decades it is obviously interesting to look for any potential benefits ,” Ros told Health Imaging.

A major problem for pancreatic surgeons dealing with the disease is that it can be difficult to accurately delineate the tumors with standard CT or MRI. Pancreatic adenocarcinoma has low vascularity, according to Ros, so contrast agents are less effective in helping to discern between the pancreas and the tumor.

Secretin, which has been used for decades by gastroenterologists in the diagnosis of pancreatitis, helps dilate the pancreatic duct and increase blood flow in the pancreas.

“What we thought…is that since it increases the vascularity it may be used not only for the evaluation of pancreatitis by [magnetic resonance cholangiopancreatography], but perhaps to increase the detection of pancreatic neoplasms,” said Ros.

In the first two patients imaged, there was an improvement in tumor visibility, but Ros cautioned against leaping to any conclusions.

“It’s just too preliminary. I mean, the concept works well as a concept and we are trying to get the data now,” said Ros. “It’s too early to tell.”

There is interest among pancreatic surgeons and gastroenterologists who are referring patients to Ros’ study, and he hopes to have a preliminary analysis at 20 cases, with a full statistical analysis at 40 cases.

According to estimates from the National Cancer Institute, more than 43,000 people were diagnosed with pancreatic cancer last year, and nearly 37,000 people died from the disease. It is the fourth-leading cause of cancer death in the U.S., with five year survival rates at 5 percent.

In many cases, the best hope for survival is to remove the tumor surgically before it spreads to other parts of the body. With better imaging techniques providing more pre-surgical information, surgery could become more effective in controlling pancreatic cancer.

“This is a somber disease. There is a lot of interest in many corners to improve either diagnosis or treatment of this particular cancer that is small in proportion, but where pretty much the incidence equals mortality at this point,” said Ros, who hopes continued research can help pancreatic cancer patients, usually diagnosed in their 60’s, enjoy many more productive and happy years of life.